NPI | 1689329971 |
---|---|
Former Name | ELAINE ELIZABETH MASTRANGELO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11017971) |
Enumeration Date | 2022-02-16 |
Last Update Date | 2022-03-08 |